From uniprofessionality to interprofessionality: dual vs dueling identities in healthcare

Khalili, Hossein; Price, Sheri

doi:10.1080/13561820.2021.1928029

Cited by 30 publications

(29 citation statements)

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“…In a pre-designed space (e.g., control rooms) where performance information is integrated and actors are gathered around common (transversal) objectives (patient experience; population health; cost reduction; care team well-being), the challenge is not so much to convince each other to work together as to find applicable, incentive-based and win-win strategies that are in line with the organization's digital capacity (e.g., fragmented information systems), governance arrangements (e.g., fragmented accountability systems) and people's values (e.g., peoplecentred health indicators). We argue that redefining performance in health care in the context of value creation is perhaps more a matter of reconciling the logics of technological, institutional and human actors in health organizations, than of reconciling the logics of different sectors and disciplines (Alami et al, 2020;Bachynsky, 2020;Khalili and Price, 2021).…”

Section: Discussionmentioning

confidence: 96%

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Appropriating integrated performance management tools in healthcare: a sociomaterial work story

Côté-Boileau

Bréton

Rouleau

et al. 2021

JHOM

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PurposeThe purpose of this paper is to explore the appropriation of control rooms based on value-based integrated performance management tools implemented in all publicly funded health organizations in Quebec (Canada) as a form of legitimate sociomaterial work.Design/methodology/approachMulti-site organizational ethnographic case studies in two Integrated health and social services centers, with narrative process analysis of triangulated qualitative data collected through non-participant observation (163 h), individual semi-structured interviews (N = 34), and document review (N = 143).FindingsThree types of legitimate sociomaterial work are accomplished when actors appropriate control rooms: 1) reformulating performance management work; 2) disrupting accountability work and; 3) effecting value-based integrated performance management. Each actor (tools, institutions and people) follows recurrent institutional work-paths: tools consistently engage in disruptive work; institutions consistently engage in maintaining work, and people consistently engage in creation work. The study reveals the potential of performance management tools as “effective integrators” of the technological, managerial, policy and delivery levels of data-driven health system performance and improvement.Practical implicationsThis paper draws on theoretically informed empirical insights to develop actionable knowledge around how to better design, implement and adapt tool-driven health system change: 1) Packaging the three agents of data-driven system change in health care: tools, institutions, people; 2) Redefining the search for performance in health care in the context of value creation, and; 3) Strengthening clinical and managerial relevance in health performance management practice.Originality/valueThe authors aim to stimulate new and original scholarship around the under-theorized concept of sociomaterial work, challenging theoretical, ontological and practical conceptions of work in healthcare organizations and beyond.

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Section: Discussionmentioning

confidence: 96%

“…We argue that redefining performance in health care in the context of value creation is perhaps more a matter of reconciling the logics of technological, institutional and human actors in health organizations, than of reconciling the logics of different sectors and disciplines (Alami et al. , 2020; Bachynsky, 2020; Khalili and Price, 2021).…”

Section: Discussionmentioning

confidence: 97%

Appropriating integrated performance management tools in healthcare: a sociomaterial work story

Côté-Boileau

Bréton

Rouleau

et al. 2021

JHOM

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“…Importantly, the module provided opportunities for students to collaborate with one another and to explicitly reflect on their socialisation into an interprofessional team. Early socialisation within an IPE setting can have implications for how a student identifies, not only as a professional within their field, but also as a professional within an interprofessional team, breaking down barriers, and disrupting disciplinary stereotyping (Khalili & Price, 2022).…”

Section: Discussionmentioning

confidence: 99%

“…IS is defined as the development of an interprofessional identity in tandem with an individual's professional identity through meaningful IPE experiences (Khalili et al, 2013;King et al, 2016). Students progress through three key stages to complete IS: breaking down barriers, interprofessional role learning, and dual identity development (Khalili & Price, 2022). Addressing the first stage is particularly important for early IPE since professional identity begins developing prior to beginning pre-licensure education and continues to develop as students are acculturated into their disciplines.…”

Section: Introductionmentioning

confidence: 99%

Socialisation into interprofessional teams: A mixed-methods study among early health professional learners who engaged in a teams and teamwork module / Sozialisierung in interprofessionellen Teams: Eine Mixed-Methods-Studie zum Effekt eines Team- und Teamwork-Moduls bei Auszubildenden im Gesundheitswesen

Rulli

Bavireddy

Smith

et al. 2022

International Journal of Health Professions

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Introduction Early health profession learners hold stereotypes about their own and other professions. Socialising students through interprofessional education (IPE) early in their training facilitates the development of their beliefs and values surrounding their professional and interprofessional identities. This study evaluates the effect of a 3-week, virtual IPE intervention in early health professional learners. Methods Students reflected on their functioning as an interprofessional team through discussion and written prompts which were coded by two faculty members for themes and trends. Exposure to developing an interprofessional identity and socialisation within an IPE team were measured through pre- and post-intervention surveys containing the Interprofessional Socialisation and Valuing Scale (ISVS). Results Students increased their positive attitudes towards IPE from pre- to post-intervention module as well as socialisation and readiness across all ISVS subscales: self-perception of working together, value, and comfort (all p < .001). Students reflected that ‘taking time to get to know each other’ (n = 23 teams; 42%) and ‘allowing everyone to contribute’ (= 17; 31%) were key factors for team development. Individual reflections on what students would work on the next time they worked in an interprofessional team revealed ‘communication’ as important (n = 87; 45%). Discussion Health profession students who engaged in the module reflected on how their interprofessional team functioned and identified what helped or hindered them to work as a team. The opportunities to reflect on how their own professional identity within the context of an interprofessional team led to evidence of socialising into an interprofessional team. Students who are challenged to socialise into a team early in their education will better understand their beliefs and values surrounding interprofessional collaboration.

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“…This professional introspection and the subsequent development of identities that align with one's profession can be historically located. In the latter half of the twentieth century, as the professions developed and specialised, they battled to define their professional roles and scope of practice, often in competition with the other professions [9,10] Many health professionals preferred to see themselves as different and even sometimes as better than other professions. Early socialization fostered a strong uniprofessional sense of the self that reproduced hierarchies of practice and stereotypical understandings of other professions [10].…”

Section: Introductionmentioning

confidence: 99%

Interprofessional identity: an ethnography of clinical simulation learning in New Zealand

Cooper-Ioelu¹,

Jowsey

2022

BMC Med Educ

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Background This article explores the experiences of clinical healthcare students on an interprofessional simulation course in Auckland, New Zealand. The four-day course aims to provide a formative learning experience for final year medical, pharmacy, nursing, and paramedicine students. It focuses on building skills in professionalism, communication, leadership and interprofessional safe teamwork through structured learning activities and clinical simulation scenarios. Methods In 2018, we commenced focused ethnographic research involving participant observation, field notes, interviews, photography and ethnographic film. Results A total of 112 students participated in this research from the disciplines of medicine (n = 53), nursing (n = 27), pharmacy (n = 17), and paramedicine (n = 15). In a revisit to Van Gennep’s (1972) seminal work on liminality, we suggest that the course represents a liminal space where students’ ideas about what it means to be a healthcare ‘professional’ are challenged, disrupted and reconstructed. We observed students emerging from the course with transformed professional and interprofessional identities. Conclusions We posit that the ritualised and liminal nature of the course plays a role in the development of interprofessional identities by interrupting the reproduction of siloed biomedical culture. Students are challenged to become effective team members alongside other students and experts from other professions. We discuss these findings as they relate to medical and health sciences education.

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From uniprofessionality to interprofessionality: dual vs dueling identities in healthcare

Cited by 30 publications

References 50 publications

Appropriating integrated performance management tools in healthcare: a sociomaterial work story

Appropriating integrated performance management tools in healthcare: a sociomaterial work story

Interprofessional identity: an ethnography of clinical simulation learning in New Zealand

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